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ACR20 – Day 1 Report

Jack Cush, MD

Friday was the first full day of scientific sessions at the 2020 Virtual ACR/ARP annual meeting. Here are my highlights from day one:

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Secukinumab in Psoriatic Arthritis Patients with Axial Disease

Sheila Reyes, MD

Results of the MAXIMISE trial show that Secukinumab provided clinical improvement and reduction in inflammatory MRI lesions in patients with psoriatic arthritis and axial disease through week 52. 

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Will we start getting fine-specificity ACPAs to drive treatment of RA? Abst#0743 shows fs-ACPA (anti-fibrinogen B) predict greater response to ABA+MTX vs MTX alone. #ACR20 @RheumNow. Role of RA antibodies will continue to evolve and guide Rx. https://t.co/pY4mm19Jc7
Eric Dein ejdein1 ( View Tweet)
Get the highlights on the opening day of #ACR20. Listen in to faculty reports and overviews. Follow the link below or find us on Apple podcasts under RheumNow Podcast. https://t.co/qDQzCAHsHi https://t.co/9nM19ZdHQQ

Links:

Dr. John Cush RheumNow ( View Tweet)

Year in review by @JYazdanyMD ENTRACTE trial: CV safety of TCZ vs. ETN >similar CV events >TCZ grp slightly more infections & GI perforations @RheumNow #ACR20 https://t.co/yBDeHBDB3Z

sheila RHEUMarampa ( View Tweet)
Should we in rheumatology be the ones leading the trials using our drugs with checkpoint inhibitors? Can we learn lessons about collaborative work from @rheum_covid? Provoking questions for the new challenges in treatment of irAEs! https://t.co/chl8TeOoMy
David Liew drdavidliew ( View Tweet)

Secukinumab has been used to treat spinal involvement in axial SpA. Secukinumab led to significant improvements in symptoms of peripheral arthritis in pts with AS. Significant improvements were seen in both tender and swollen joints @RheumNow #ACR20 Abstr#366

Dr. Antoni Chan synovialjoints ( View Tweet)

If TCZ blunts CRP a lot/ESR a fair bit, how can we pick GCA relapses in pts on TCZ? Cool tech (mass spec w tandem mass tag multiplex) on GiACTA samples. Of 344 candidate proteins, guess what ranked highest? Haptoglobin. Let's validate! @MGHrheumatology #ACR20 ABST0513 @RheumNow https://t.co/ErmqZuf2iu
David Liew drdavidliew ( View Tweet)
Better outcomes (ASAS20 and ASAS40 @wk 52) seen in younger pts (possibly lower disease duration) when Secukinumab was given to ankylosing spondylitis pts. Early Dx in #AS! #ACR20 Abstr#0350 https://t.co/EKks0b1upc https://t.co/bxIH9lloI1

Links:

Dr. John Cush RheumNow ( View Tweet)
Still more interesting lessons from GiACTA, this time re: nature of GCA flares on TCZ: - visual manifestation flares were rare - ESR or CRP raised in 3/4 of flares (so not raised in 1/4) Understanding these flares is crucial! Unizony et al @MGHMedicine #ACR20 ABST0516 @RheumNow https://t.co/WVIitov7Ut
David Liew drdavidliew ( View Tweet)
Shoutout to @SattuiSEMD and @NavarroMillanMD showing #dementia is lower in #RA pts on bDMARDs compared to csDMARDs using CMS data #ACR20 ABS#0488 @RADoctor @RheumNow https://t.co/1XOV2zqKko
Bella Mehta bella_mehta ( View Tweet)

DISCOVER-2 (52 wk study) Guselkumab 100mg q4wk and q8wk for tx of PsA 1️⃣Sustained responses in: ACR20/50/70, PASI90/100, HAQ-DI, MDA/VLDA, QoL 2️⃣Improvement enthesitis/dactylitis 3️⃣No increase rate of serious infection @RheumNow #ACR20 Abs#0506 https://t.co/7MXYTucVZ9

Robert B Chao, MD doctorRBC ( View Tweet)
IL-6 blockade for management of irAEs without inhibiting anti cancer immune response. Should these be given prior or concomitantly with ICIs? Some interesting ideas to look up from the cancer and immunotherapy study group. #ACR20 @UTSWNews @ACRheum @RheumNow

Adela Castro AdelaCastro222 ( View Tweet)

More UPA safety studies Abst#0215 shows balanced VTE event rates across UPA doses and comparator groups. Evidence for Dr. Strand to use in #ACR20 Great Debate that VTE may be safe TNF alternative @RheumNow. https://t.co/hByttIxiuX
Eric Dein ejdein1 ( View Tweet)
What's your initial biologic of choice when escalating therapy for PsA patients non-responsive to csDMARDs? @RheumNow #ACR20

sheila RHEUMarampa ( View Tweet)

Extended 5 year study of secukinumab in AS patients showed sustained improvement of back pain, nocturnal back pain, AM stiffness, fatigue and LDA Abs#0364 @RheumNow #ACR20

Robert B Chao, MD doctorRBC ( View Tweet)

The Great Debate results! https://t.co/tJk0yIRqfK
Dr. Rachel Tate uptoTate ( View Tweet)
RheumNow’s expanded coverage of the #ACR20 Annual meeting is sponsored in part by BMS, @HorizonNews , @SanofiGenzyme, @Novartis. All content chosen by RheumNow & its Faculty.

Dr. John Cush RheumNow ( View Tweet)

How would you change csDMARDS and bDMARDS a few days before vaccination - if/when #COVID19 KILLED vaccine comes in (Assuming live vaccine would need strict medication management.) #ACR20 @RheumNow

Bella Mehta bella_mehta ( View Tweet)

DVT/PE has been the sticking point for baricitinib in RA. DVT/PE risk in integrated safety analysis >8y: incidence doesn't increase, but also doesn't decrease. No diff with dose either. Every drug has pros/cons; it's how we manage risk that counts... #ACR20 ABST0202 @RheumNow https://t.co/V88tQjcXSJ
David Liew drdavidliew ( View Tweet)
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